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- 저자 : 문주형 ( Ju Hyung Moon ) (검색결과 1 건)
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임상 : 대후두공과 상위경추신경 전방으로의 극외측경과접근법; 수술술기와 22예의 임상분석
문주형 ( Ju Hyung Moon ),홍창기 ( Chang Ki Hong ),김창현 ( Chang Hyun Kim ),안정용 ( Jung Yong Ahn ),장종희 ( Jong Hee Chang ),이규성 ( Kyu Sung Lee ) 대한뇌종양학회 2009 대한뇌종양학회지 Vol.8 No.2
Objective:Because diseases that are situated anterior to the foramen magnum, lower clivus, and the upper cervical spinal canal permit only limited access, they are considered some of the most difficult intracranial lesions to surgically treat. The far-lateral transcondylar approach provides such a route. The author has reviewed the technique as well as the surgical results here. Methods:During a 6-year period 22 patients underwent surgery in which far-lateral approach were performed. This approach to the craniocervical junction was utilized in patients with aneurysm, schwannoma, meningioma, and chordoma affecting the cervicomedullary junction. Medical records, including imaging studies, descriptions of microsurgical findings, photographs, and video records of operative procedures, were reviewed. Mean follow up period was 4.4 years. Results:Total tumor resection was achieved in 16 patients, and a subtotal resection of the tumor was performed in the other 4 patients. In the 2 patients with vertebral artery-posterior inferior cerebellar artery(PICA) aneurysms, 1 underwent clipping, the other underwent trapping and occipital artery-PICA bypass procedure. Postoperative complications included CSF leak in 4 and temporary low cranial nerve dysfunction in 4. There was no significant postoperative complication in the remainder of the patients, and their conditions improved after surgery. Conclusion:Successful surgical management of anterior foramen magnum lesion depends on precise understanding of their unique microsurgical anatomy, avoidance of pitfalls, and the surgeon`s experience. Sufficient exposure, minimal brain retraction, and preservation of the lower cranial nerves are necessary for a safe surgery.
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